WOUNPS. 



into the conftitution ought to be prevented, if poflible. 

 This is more likely to be accompliflied than any aim at 

 neutrahzing the venomous fluid, after its effefts have ex- 

 tended to the whole animal economy. 



Even wfhen the bite of a viper is entirely neglefted, it 

 very rarely proves fatal to the human fubjeft. In many 

 cafes, the patients have recovered favourably under the mere 

 ufe of olive-oil and of ammonia. Thefe two medicines have 

 been recommended as fpecifics both in the Tranfaftions of 

 the Royal Society, and by the celebrated Bernard de 

 Juflieu ; and amongfl the cafes in proof of their efficacy, 

 authors ilill continue to quote the example of a dealer in 

 vipers, who was quite indifferent about being bitten by thefe 

 animals. He ufed to bathe the part in olive-oil, and at the 

 fame time drink feveral ounces of this fluid. And in an- 

 other inftance, which is frequently cited, a ftudent of 

 botany, while herborizing, was bitten by a viper in a place 

 where no medicine was at hand, except the eau de luce. 

 Juflieu, who was prefent, introduced a few drops of this 

 remedy into the wound, and adminiftered a tea-fpoonful of 

 it internally in a glafs of water. The eau de luce is nothing 

 •more than the liquor ammoniae, containing a fmall quantity 

 of the oleum fuccini. 



In France, and in other parts of the continent, the eau de 

 luce is ftill looked upon as the internal medicine, on which 

 moft reliance can be placed. 



In this country, arfenic, in ftrong dofes, has been par- 

 ticularly recommended for its beneficial effe£ls in counter- 

 afting the operation of the poifon of fnakes. The Tanjore 

 pill, which has long been famous'in India for its virtues in 

 preventing the fatal fymptoms arifing from the bites of fer- 

 pents in hot countries, was known to have arfenic as one of 

 its ingredients. Mr. Ireland, an army furgeon, happened 

 to be at St. Lucia, in the Weft Indies, when feveral men 

 of the 62d regiment were bitten by the coluber carinatus of 

 Linnseus, the bite of which had already proved quickly 

 fatal to feveral men of the fame corps. Mr. Ireland im- 

 mediately adminiftered Fowler's folution of arfenic in ftrong 

 dofes, and the refults of the cafes, in which he had an op- 

 portunity of trying it, were highly favourable to the 

 praftice, as the men's lives were preferved by it. (See 

 Medico-Chir. Tranf. vol. ii. p. 393, &c.) Perhaps the 

 prompt excifion of the bitten part, or the free ufe of the 

 aftual cautery, ftiould alfo be invariably put in praftice, for 

 the bites of the more deadly kinds of ferpents, in conjunc- 

 tion with the exhibition of arfenic. But the ordinary con- 

 fequences of the bite of a common adder are not ferious 

 enough to require fo fevere a proceeding as the excifion or 

 amputation of the parts would often be. Some obfervations 

 on the ftrufture of the viper will be found in the article 

 Coluber, and other remarks on the bite of this animal will 

 be feen in the articles Poison and Viper. 



The worft poifoned wounds ever met with in this climate 

 are thofe produced by the bite of a mad dog, and other 

 rabid animals ; but for a particular account of this highly 

 interefting fubjeft, we muft refer to Hydrophobia. 



Wounds of different Parts of the Face, Eye, Eye-lids, 

 Ears, i^c — The countenance being the part in which any 

 deformity is pecuharly confpicuous, it is always a great 

 defideratum, in cafes of wounds of the forehead, cheeks, 

 nofe, lips, &c. to prevent as much as poffible the formation 

 of ugly fcara. Hence it is an invariable maxim to endeavour 

 to heal wounds of the face by the firft intention. 



As cuts of the face can hardly be very deep, adhefive 

 plafter is generally fufScient for holding their oppofite edges 

 together ; but when the wound is fituated in the lips, thefe 



parts are fo inceflantly in motion, that furgeons find it heft 

 to maintain the fides of the divifion in contaft by means 

 of the twifted future, a defcription of which is given in the 

 article Harelip. 



When the edges of a wound of the lips are much con- 

 tufed and lacerated, fome authors recommend them to be 

 pared off, in order to increafe the chance of union, and- 

 leflen the disfigurement of an uneven cicatrix. 



Punftures of the tranfparent cornea of the eye are in 

 themfelves much lefs ferious accidents than fimilar injuries 

 of the fclerotic coat, which are almoft unavoidably com- 

 bined with a wound of the choroides and retina. Hence, 

 the latter cafes are frequently followed by a confidevable 

 degree of inflammation. Sometimes the cryftalline lens 

 itfelf is injured, and afterwards grows opaque. 



Incifions made in the tranfparent cornea with very fliarp 

 inftruments may not give rife to any ferious confequences ; 

 and notwithftanding the efcape of the aqueous humour, the 

 cryftalline lens and vitreous humour may remain in their 

 natural fituation. The form, thicknefs, and denfity of the 

 cornea are circumftances which produce a fpontaneous ap- 

 proximation of the edges of the wound to each other, and 

 which, in faft, are extenfively in contaft. But the co- 

 aptation is rendered very exaft, and a quick re-union much 

 promoted, by drajving down the upper eye-lid, fo as to (hut 

 the eye ; in which ftate, the cartilaginous tarfus of the 

 upper eye-Ud makes an uniform compreflion on the cornea, 

 in a manner which is extremely ufeful. Cuts of the fclerotica 

 are not in general fo Cmple. The choroides and retina may 

 be at the fame time either divided or expofed. In the firft: 

 cafe, the expulfion of the whole of the vitreous humour, 

 and a total diforganization of the eye, are to be apprehended 

 from the immediate fpafmodic contraftion of the raufcles of 

 this organ ; and, in the fecond, a violent and dangerous 

 ophthahny is to be expefted. When, in the inftance of a 

 large wound of the fclerotica, choroides, and retnia, the 

 contents of the eye-ball are difcharged, the organ inflames, 

 and gradually (brinks into a much f mailer mafs, which is 

 moveable, and capable of fupporting an artificial eye. 



Contufed wounds of the eye-ball are moftly followed by 

 a dettruftion of the funftions of the organ, either in confe- 

 quence of the concuflion of the retina, or of the inflammation 

 to which thefe injuries ufually give rife. However, in a few 

 cafes, even contufed wounds of the eye have united very 

 favourably, and without the lofs of vifion. Sometimes the 

 folution of continuity extends through the fclerotica, while 

 the conjun6tiva itfelf is not ruptured. Delpech affirms, that 

 he has feen feveral fuch cafes, in which the latter membrane 

 prefented the appearance of an ecchymofis oppofite the divi- 

 fion of the fclerotica, and confined the humours of the eye, 

 which othcrwife would have been loft. Precis des Maladies 

 Chir. torn. i. p. 349. 



Nothing is more hkely than gun-lhot wounds to produce 

 a violent concufiiion of the retina, and an incurable paralyfis 

 of this nervous expanfion. The fmalleft particle of lead, 

 which either ftrikes or penetrates the eye-ball, may occafion 

 thofe effefts. Every other fevere contufion of the eye may 

 aft in the fame way. When the extravafation of blood ori- 

 ginating from an accident of this kind is not attended with a 

 ferious concuifion of the retina, the eS"ufed blood will be 

 abforbed, and the funftions of the eye reftored. 



In all cafes of wounds of the eye, fays M. Delpech, 

 there are three fundamental indications ; firft, to prevent 

 the expulfion of the vitreous humour and cryftaUine lens ; 

 fecondly, to promote the quick re -union of the wound by 

 placing its edges very accurately together ; and tlurdly, to 



do 



